Arrhythmias newly provoked by exercise training in patients who underwent cardiac surgery

We investigated the incidence and the varieties of arrhythmia during exercise training in patients who underwent cardiac surgery. Subjects were 1293 patients who underwent cardiac surgery and enrolled our cardiac rehabilitation program. According to the charts and cardiac rehabilitation records, we evaluated the incidence and the varieties of arrhythmia provoked by exercise training in patients after cardiac surgery retrospectively. The arrhythmias related to the exercise training were provoked in 12 times, and the incidence was only 0.09% (12/13646). Atrial fibrillation was the most common arrhythmia, and the incidence was 41.6% (5/12) in these patients. Moreover, these arrhythmias occurred within 2 weeks after surgery. Although most patients recovered to the sinus rhythm spontaneously, 3 patients needed medical treatment or cardioversion. We concluded that the arrhythmia provoked by exercise training in patients after cardiac surgery were rare, non-fatal, and common in the early recovery phase after surgery. However, the supervised exercise training was required in those patients, particularly in early recovery phase of cardiac surgery.     

A prospective survey of delayed adverse reactions to iohexol in urography and computed tomography

We investigated 7505 inpatients who underwent intravenous urography or contrast-enhanced computed tomography to assess risk factors for delayed adverse drug reactions to iohexol, a non-ionic iodinated contrast medium. Focusing on delayed adverse reactions, all adverse events were prospectively investigated for 7 days after injection of iohexol. To explore the relevant risk factors, the relationship between occurrence of adverse reactions to iohexol and 17 different variables was evaluated by logistic regression analysis. To assess the influence of seasonal factors, adverse reactions were separately evaluated during two periods: February to April (the pollinosis period in Japan) and July to September (the non-pollinosis period). The prevalence of delayed adverse events and delayed adverse reactions was 3.5 and 2.8%, respectively, whereas the prevalence of adverse events and adverse reactions was 5.7 and 5.0%, respectively. Multivariate analysis showed that six parameters had a significant influence on delayed adverse reactions to iohexol, including (a) a history of allergy, (b) season, (c) radiographic procedure, (d) age, (e) concomitant surgery or other invasive procedures, and (f) concomitant medication. The prevalence of delayed reactions was lower than in previous large-scale studies. Significant risk factors included a history of allergy and performance of radiography during the pollinosis period, suggesting that allergy was involved in delayed adverse reactions. The type of radiographic procedure also had an influence. Electronic Publication     

HIV-1 integrase inhibitory substances from Coleus parvifolius

For the purpose of discovering anti-HIV-1 agents from natural sources, water and EtOH extracts of 50 Thai plants were screened for their inhibitory activity against HIV-1 integrase (IN), an enzyme essential for viral replication. Of these plants, an EtOH extract of Coleus parvifolius Benth. (aerial parts) showed potent activity against HIV-1 IN with an IC50 value of 9.2 microg/mL. From this extract, 11 compounds were isolated and identified as luteolin 5-O-beta-d-glucopyranoside (1), luteolin (2), luteolin 7-methyl ether (3), luteolin 5-O-beta-d-glucuronide (4), 5-O-beta-d-glucopyranosyl-luteolin 7-methyl ether (5), rosmarinic acid (6), rosmarinic acid methyl ester (7), daucosterol (8), a mixture of alpha- and beta-amyrin (9, 10) and phytol (11). Of these compounds, rosmarinic acid methyl ester (7), rosmarinic acid (6), luteolin (2) and luteolin 7-methyl ether (3) exhibited inhibitory activities against HIV-1 IN with IC50 values of 3.1, 5.0, 11.0 and 11.0 microM, respectively. Among rosmarinic acid derivatives, the HIV-1 IN inhibitory activity increased in turn for a dimer (IC50 = 5.0 microM), a trimer (IC50 = 1.4 microM), and a tetramer (IC50 = 1.0 microM).     

Cholesteryl-hemisuccinate-induced apoptosis of promyelocytic leukemia HL-60 cells through a cyclosporin A-insensitive mechanism

We reported previously that alpha-tocopheryl-succinate (VES) induced apoptosis of cultured human promyelocytic leukemia cells (HL-60) (Free Radic Res 2000;33:407-18). We have now studied the effect of cholesteryl-hemisuccinate (CS) on the fate of HL-60 cells to clarify whether CS has an effect similar to that of VES. CS inhibited the growth of HL-60 cells without differentiation to granulocytes and induced DNA fragmentation and ladder formation. CS inhibited the phosphorylation of pleckstrin homology domain-containing protein kinase B (Akt) and initiated the activation of a caspase cascade. CS triggered the reaction leading to the cleavage of Bid and also released cytochrome c (Cyt. c) from mitochondria. In addition, CS induced mitochondrial membrane depolarization and translocation of Bax to mitochondria in HL-60 cells. However, CS did not induce an increase in the concentration of intracellular calcium ions in HL-60 cells. The membrane depolarization, Cyt. c release, and DNA fragmentation were inhibited by z-VAD-fluoromethylketone (z-VAD-fmk), a pan-caspase inhibitor, but not by cyclosporin A, an inhibitor of membrane permeability transition. These results suggested that CS-induced apoptosis of HL-60 cells might be caused by inhibiting Akt phosphorylation following cleavage of Bid through caspase-8 activation and subsequently via an Apaf complex-caspase cascade pathway.     

Successful treatment of a<Emphasis Type="Italic">Salmonella</Emphasis> aortic arch aneurysm

A 52-year-old man hospitalized for hoarseness and chest pain was found in chest computed tomography to have an impending aortic arch aneurysm rupture. Laboratory studies showed the presence of severe inflammation. Based on a clinical diagnosis of infected aortic arch aneurysm, we conducted total arch replacement.Salmonella was identified in the aneurismal wall and antibiotics were administered longterm. The postoperative course was uneventful. The patient was discharged on postoperative day 48. He has remained afebrile and asymptomatic in the 10 months since surgery but continues to take 300 mg/d of oral levofloxacin.     

Possibility of "distraction arthrogenesis": first report in rabbit model

We investigated the possibility of articular cartil-age distraction for use in reconstructing joint structure and for increasing the donor site of osteochondral grafts. Intraarticular osteotomy was performed at the femoral condyle in 12 Japanese white rabbits. The bone segment was fixed with a specially designed external fixator. After a 3-week waiting period, distraction was performed intermittently for 3 weeks (0.7 mm × 3 times per week) in the distraction group (n = 7) and, in the remaining animals (gap group; n = 5), a gap of 6.3 mm in length was made at surgery. All rabbits received etidronate injections (20 mg/kg ×2 times per week) for 5 weeks, to slow mineralization. The femoral condyle was harvested 9 weeks postoperatively and decalcified sagittal sections were stained and evaluated, using a histological grading scale. In the distraction group, distraction of 4.2 ± 1.4 mm was achieved, and the distracted cartilage area was filled with regenerated cartilage, without any gap between the regenerated and the adjacent articular cartilage. This regenerated cartilage showed metachromasia with toluidine blue. In the gap group, newly formed cartilage tissue was folded from the edge of the osteotomy site and fibrous tissue was interposed in the gap. The histological grading score was significantly lower in the distraction group (P < 0.02). Our preliminary results demonstrated the possibility of cartilage distraction; however, long-term observation will be necessary to confirm the characteristics of the distracted cartilage. We may call the process "distraction arthrogenesis", because the entire articular entity, which consists of cartilage, subchondral bone, and bone, could be distracted at once. Received: April 5, 2001 / Accepted: July 15, 2001     

Chronic treatment with a PDE5 inhibitor increases contractile force of normal bladder in rats

Objectives  

We have previously shown that a phosphodiesterase 5 (PDE5) inhibitor, vardenafil, possesses bladder protective effects in bladder outlet obstruction (BOO) rats by preserving contractile force. In this study, we examined the effects of vardenafil to obtain clues for further research elucidating the mechanism of action of vardenafil on rat normal bladder.     

Enhanced blood pressure response to regular daily stress in urban hypertensive men

Twenty-eight urban untreated hypertensive men (mean age: 54 years; systolic (SBP)/diastolic (DBP) blood pressure at clinic: 148/96 mmHg] and 26 age- and sex-matched normal controls (54 years, 118/78 mmHg) were examined during normal daily activities by ambulatory blood pressure monitoring. When compared with home blood pressures, clinic blood pressures were 8/10% (SBP/DBP) higher in the hypertensives, but 1/3% lower in the normotensives. The values were significantly different for both groups (P less than 0.01 for SBP; P less than 0.001 for DBP). In contrast, the blood pressures fell in a similar manner in both groups during sleep. On working days, the blood pressures during work were 10/9% higher than the corresponding home blood pressures in the hypertensives and only 3/3% higher in the normotensives. These differences were significant (P less than 0.01 for both SBP and DBP). The results show that the blood pressures of hypertensives were hyperreactive to casual daily stress. In the normotensives, left ventricular wall thickness determined by echocardiography was correlated significantly with the blood pressures during work (r = 0.5, P less than 0.05 for SBP and DBP) and at home (r = 0.4, P less than 0.05 for SBP).